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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004609
Report Date: 02/06/2025
Date Signed: 02/06/2025 04:33:32 PM

Document Has Been Signed on 02/06/2025 04:33 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PANDA CHILDREN'S CENTERFACILITY NUMBER:
384004609
ADMINISTRATOR/
DIRECTOR:		QI, WENFACILITY TYPE:
850
ADDRESS:2124 TARAVAL STREETTELEPHONE:
(415) 234-3096
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 11DATE:
02/06/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:31 PM
MET WITH:Wen QiTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On February 6, 2025, Licensing Program Analysts (LPAs) Van and Badger conducted a case management inspection in conjunction with the Plan of Correction. The purpose of this inspection was to address a violation discovered during the annual inspection on January 9, 2025. During a review of personnel files on that date, it was found that the Director had deliberately altered her Mandated Reporter training certificate twice by changing the certificate holder's name to reflect her own. This discrepancy was uncovered when the QR code on the certificate was scanned, revealing that the certificate rightfully belonged to one of her teachers. As a result, a Type A deficiency has been cited today.

LPA Van informed the Director, Wen QI, that this report dated February 6, 2025, document(s) a Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Van informed the Director to provide a copy of this licensing report dated February 6, 2025, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) or other written statement must be placed in the child's file for verification.

Exit interview conducted, and the report was reviewed with the Director, Wen Qi.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/06/2025 04:33 PM - It Cannot Be Edited


Created By: Brendon Van On 02/06/2025 at 04:19 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PANDA CHILDREN'S CENTER
FACILITY NUMBER: 384004609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2025
Section Cited
CCR
101163(a)

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101163 False Claims (a)No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the child care center or any of the services provided by the center.

This requirement was not met as evidenced by:
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The licensee is scheduled to attend an informal meeting at the Regional Childcare office located in San Bruno. A formal notification will be sent to the Center and Licensee at a later date.
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Based on the record review, the Center did not comply with the section cited above. it was revealed that the Director had deliberately altered her Mandated Reporter training certificate by changing the name of the certificate holder to reflect her own. This discrepancy was uncovered when the QR code on the certificate was scanned, which indicated that the certificate rightfully belonged to one of her teachers. This poses an immediate health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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